Future cardiology最新文献

{"title":"Evaluating sotatercept in the treatment of pulmonary arterial hypertension.","authors":"William Salibe-Filho, Nathalia Zorze Rossetto, Luiza Sarmento Tatagiba, Yuri de Deus MontAlverne Parente, Carlos Viana Poyares Jardim, Caio Julio Cesar Fernandes, José Leonidas Alves-Junior, Rogerio Souza","doi":"10.1080/14796678.2026.2659085","DOIUrl":"10.1080/14796678.2026.2659085","url":null,"abstract":"<p><p>Pulmonary arterial hypertension (PAH) is a progressive disease characterized by pulmonary vascular remodeling, right ventricular overload, and premature death. Despite advances achieved through endothelin receptor antagonists, phosphodiesterase type 5 inhibitors, and prostacyclin analogs, these agents primarily act as vasodilators and do not reverse underlying vascular pathology. Sotatercept, a first-in-class activin signaling modulator, restores the balance between pro- and antiproliferative signaling within the pulmonary vasculature via the TGF-β/activin-BMPR2 pathway, offering a novel disease-modifying mechanism. Following encouraging preclinical data, a series of clinical trials, PULSAR, SPECTRA, STELLAR, ZENITH, and HYPERION, demonstrated consistent efficacy across diverse PAH populations. Sotatercept significantly reduced pulmonary vascular resistance, improved exercise capacity, and decreased morbidity and mortality, including in patients receiving maximal background therapy. Across studies, adverse events were generally mild to moderate, with epistaxis, telangiectasia, and increased hemoglobin being the most common treatment-related events. Collectively, these findings establish sotatercept as a major advance in PAH therapy, marking a transition from purely vasodilatory approaches toward targeted modulation of vascular remodeling. By improving pulmonary hemodynamics and right ventricular function, sotatercept represents a new therapeutic option for improving clinical outcomes across different stages of PAH.</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"463-472"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13215286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of fatal neonatal dilated cardiomyopathy in an infant of a diabetic mother.","authors":"Zakaria Yusuf Hassan, Abdullahi Abdulkadir Hashi Elmi, Abdihafid Mohamed Abdullahi","doi":"10.1080/14796678.2026.2662011","DOIUrl":"10.1080/14796678.2026.2662011","url":null,"abstract":"<p><p>Dilated cardiomyopathy (DCM) is the most common pediatric cardiomyopathy and a leading cause of heart failure and cardiac transplantation in children. While a rare complication of maternal diabetes, the dilated phenotype of Infant of a Diabetic Mother (IDM) cardiomyopathy carries a high risk of morbidity and mortality. We report a term female neonate born to a mother with poorly controlled gestational diabetes (HbA1c 8.0%) who developed severe cardiogenic shock within 24 hours of life. Echocardiography confirmed DCM with profound biventricular dysfunction (initial left ventricular ejection fraction [LVEF] 28%, deteriorating to <17% within 5 days) and associated left ventricular non-compaction (LVNC) morphology. Despite maximal medical therapy, the infant's condition deteriorated, and she died on day 11 of life. Comprehensive diagnostic workup for alternative etiologies was limited by the rapid clinical course. This fatal case highlights the potential severity of the dilated form of IDM cardiomyopathy, which can be rapidly progressive and refractory to treatment. It underscores the critical importance of optimal glycemic control in pregnancy while acknowledging that alternative genetic or metabolic etiologies cannot be definitively excluded. This presentation should be recognized as a high-risk clinical entity distinct from the more common and often transient hypertrophic form.</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"473-477"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13215303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147768507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of chronic total occlusion on outcomes following transcatheter aortic valve implantation: a systematic review and meta-analysis.","authors":"Kyriakos Dimitriadis, Nikolaos Pyrpyris, Eirini Beneki, David Meier, Angelos Papanikolaou, Eirini Dris, Panagiotis Theofilis, Panagiotis Antiochos, Stephane Fournier, Georgios Tzimas, Konstantinos Aznaouridis, Konstantinos Tsioufis","doi":"10.1080/14796678.2026.2664534","DOIUrl":"10.1080/14796678.2026.2664534","url":null,"abstract":"<p><strong>Aim: </strong>The pre-procedural presence of chronic total occlusions (CTO) in patients undergoing transcatheter aortic valve implantation (TAVI) could be a significant predictor of outcomes. This meta-analysis aims to investigate whether CTO presence significantly alters outcomes in TAVI patients.</p><p><strong>Methods: </strong>A systematic search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. After study selection, a random effect meta-analysis was performed.</p><p><strong>Results: </strong>Seven studies with a total of 15,162 patients undergoing TAVI were included. There was no significant difference regarding in-hospital [Relative Risk (RR): 1.13; 95% Confidence Interval (95% CI): 0.82-1.55] and 1-year all-cause mortality (RR: 1.58; 95% CI: 0.71-3.50). Patients with CTO exhibited significantly increased rates of myocardial infarction (RR: 1.27, 95% CI: 1.07-1.51) and reduced rates of new pacemaker implantation (RR: 0.88, 95% CI: 0.79-0.98). No differences were found in cardiogenic shock (RR: 1.18, 95% CI: 0.97-1.44), acute kidney injury (RR: 1.06, 95% CI: 0.88-1.28), vascular complications (RR: 1.10, 95% CI: 0.91-1.33), or bleeding (RR: 1.01, 95% CI: 0.89-1.14).</p><p><strong>Conclusion: </strong>In TAVI patients, pre-procedural unrevascularized CTO presence is not related to short- or mid-term increased mortality. Further studies are needed to identify predictors of adverse events and phenotypes benefiting from revascularization.</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"487-496"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13215309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147768868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent updates in the management of atrial fibrillation in patients with cardiac amyloidosis.","authors":"Marta Lorente-Ros, Flavia Tejada Frisancho, Francisca Bermudez, Luyun Chen, Rama A Alashqar, Jillian Marianos, Tania Vora, Connor P Oates, Farooq H Sheikh","doi":"10.1080/14796678.2026.2671774","DOIUrl":"10.1080/14796678.2026.2671774","url":null,"abstract":"<p><p>Left atrial myopathy in cardiac amyloidosis leads to structural, functional, and electrophysiologic changes in the left atrial myocardium that create substrate for atrial fibrillation. As a result, the incidence and prevalence of atrial fibrillation in patients with cardiac amyloid exceeds that of other cardiomyopathies. Management of atrial fibrillation in patients with cardiac amyloidosis is particularly challenging given poor hemodynamic tolerance to rate control, limited safety profile of antiarrhythmic drugs, and modest long-term effectiveness of rhythm control strategies. Data on outcomes after cardioversion and catheter ablation are based on retrospective observational studies with small sample size, making it difficult to understand the impact of rhythm control in cardiovascular outcomes of these patients. Moreover, patients with cardiac amyloidosis have a higher risk of thromboembolism than that of other populations with atrial fibrillation, along with a higher risk of bleeding due to alteration in coagulation pathways and fragility of vasculature infiltrated by amyloid fibrils. Decision-making on stroke prevention strategies therefore demands a careful and individualized risk assessment for each patient. In this review, we explore the intricacies of the association between atrial fibrillation and cardiac amyloidosis, including epidemiology, mechanisms of atrial arrhythmia, management considerations, as well gaps in research and future directions.</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"497-514"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13215305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147963293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-hospital mortality after pericardiocentesis: role of effusion etiology and hemodynamic physiology.","authors":"Nabeel Sami, Laura Bradel, Gioia Turitto","doi":"10.1080/14796678.2026.2664532","DOIUrl":"10.1080/14796678.2026.2664532","url":null,"abstract":"<p><strong>Aims: </strong>This study evaluated the impact of effusion etiology, hemodynamic presentation, and comorbidity burden on in-hospital outcomes following pericardiocentesis.</p><p><strong>Patients and methods: </strong>A retrospective analysis of 62 adults who underwent pericardiocentesis at a tertiary academic hospital (2021-2024) was performed. The primary outcome was in-hospital mortality. The Charlson Comorbidity Index (CCI) and a post hoc Pericardial Risk Score (PRS) were evaluated as predictors.</p><p><strong>Results: </strong>Median age was 72 years (55% male; median CCI 2). Complications occurred in 13% and recurrence in 10%. In-hospital mortality was 8.1% (5/62), limited to malignant, ischemic, infectious, or anticoagulation-related effusions. The PRS showed a stepwise increase in mortality from 0% (PRS 0) to 25% (PRS 2) (<i>p</i> = 0.037), while the CCI did not predict mortality (<i>p</i> = 0.27).</p><p><strong>Conclusions: </strong>Pericardiocentesis remains safe and effective with low recurrence. Mortality is driven by effusion etiology and hemodynamic severity rather than comorbidity burden. A simple etiology-physiology risk score outperformed the CCI and may help guide post-procedural management.</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"479-486"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13215328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147768945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rheumatic heart disease and mitral stenosis.","authors":"David Ho, Tony Li, Ryan Leow, Ching Hui Sia","doi":"10.1080/14796678.2026.2647664","DOIUrl":"10.1080/14796678.2026.2647664","url":null,"abstract":"<p><p>Rheumatic heart disease (RHD) remains a leading cause of mitral stenosis (MS), particularly in developing countries like India, China or countries within Africa. Characterized by a long latent phase after acute rheumatic fever, rheumatic MS often leads to significant morbidity and mortality. This paper explores its epidemiology, natural history, and clinical consequences, including associations with atrial fibrillation, pulmonary hypertension, heart failure, systemic embolism, and infective endocarditis. We review diagnostic tools, particularly echocardiography, and management strategies such as balloon mitral commissurotomy and surgical interventions. Emerging therapies, including lithotripsy-facilitated procedures and trans-catheter valve replacement, offer promise for high-risk patients. Early detection and comprehensive care are essential to reduce the global burden of rheumatic MS.</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"541-555"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13215325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147813795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent advances in predicting and improving outcomes in patients undergoing transcatheter tricuspid valve intervention.","authors":"Lisa Serafini, Alessandra Ricci, Elisa Pezzola, Michele Legati, Francesca Capasso, Francesca Pugno Vanoni, Oliviana Geavlete, Ovidiu Chioncel, Marco Metra, Marianna Adamo","doi":"10.1080/14796678.2026.2652420","DOIUrl":"10.1080/14796678.2026.2652420","url":null,"abstract":"<p><p>Tricuspid regurgitation (TR) has long been underestimated, traditionally viewed as a benign condition, yet contemporary evidence demonstrates its high prevalence and substantial adverse prognostic implications. Medical therapy remains limited, and although surgery has historically been the standard of care, many patients are referred at advanced stages, contributing to poor operative outcomes. Transcatheter tricuspid valve interventions (TTVI) have emerged as a valuable therapeutic option, showing consistent improvements in symptoms, quality of life (QoL), and heart failure hospitalizations (HFH), although a definitive survival benefit has not yet been established. Optimal management requires a comprehensive, multiparametric, and multidisciplinary approach. Key elements include careful assessment of TR etiology, clinical status, right heart failure stage, multimodality imaging, risk scores, and invasive hemodynamics. Integrating these factors enables appropriate patient selection, individualized treatment strategies, and avoidance of futile procedures. Ultimately, decisions regarding intervention and device choice should be guided by a dedicated multidisciplinary Heart Team within a specialized Heart Valve Center.</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"515-527"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13215622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147672352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing adverse events after percutaneous coronary intervention: the benefits of a personalized approach to dual antiplatelet therapy.","authors":"Felice Gragnano, Vincenzo De Sio, Giuseppe Verde, Paolo Calabrò","doi":"10.1080/14796678.2026.2649866","DOIUrl":"10.1080/14796678.2026.2649866","url":null,"abstract":"","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"459-461"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13215322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147573407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uni-leaflet mitral valve in adults: a systematic review of case reports and case series.","authors":"Martina Mookadam, Safiyya A Mookadam, Michael Morris, Sandip Pradhan, Farouk Mookadam","doi":"10.1080/14796678.2026.2659088","DOIUrl":"10.1080/14796678.2026.2659088","url":null,"abstract":"<p><strong>Introduction: </strong>Uni-leaflet mitral valve (ULMV) is a rare congenital anomaly historically considered incompatible with long-term survival, yet increasing reports describe diagnosis in adulthood. We conducted a systematic review to characterize clinical presentation, anatomy, imaging findings, management, and outcomes in adults with ULMV.</p><p><strong>Methods: </strong>Following PRISMA guidelines, major databases were searched from 1960 through January 2024. Eligible studies reported adult patients with confirmed ULMV. Data were extracted on demographics, valve morphology, symptoms, associated anomalies, imaging modalities, interventions, and outcomes.</p><p><strong>Results: </strong>Thirty-six publications comprising 40 adult patients met inclusion criteria. Mean age at diagnosis was 50.5 years, with female predominance. Posterior leaflet hypoplasia or agenesis accounted for 97.5% of cases. Most patients were symptomatic, commonly with dyspnea or heart failure, and over half had moderate or greater mitral regurgitation. Atrial fibrillation, atrial septal defects, and aortic valve abnormalities were frequent comorbidities. Transthoracic echocardiography was used universally, with transesophageal and three-dimensional imaging providing incremental anatomical detail. Approximately one-third underwent mitral valve repair or replacement, with generally favorable outcomes.</p><p><strong>Conclusions: </strong>Adult ULMV demonstrates marked clinical and anatomical heterogeneity and may represent a developmental spectrum rather than a single entity. Standardized definitions and prospective registries are needed to improve risk stratification and guide management.</p><p><strong>Protocol registration: </strong>http://www.crd.york.ac.uk/prospero identifier is CRD420251083213.</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"557-565"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13215293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of multi-marker stress echocardiography.","authors":"Eugenio Picano, Angela Zagatina, Lauro Cortigiani, Ratnasari Padang, Garvan C Kane, Hector R Villarraga, Adelaide M Arruda-Olson, Jorge Lowenstein, Rosina Arbucci, Hugo Rodriguez-Zanella, Ayten Safarova, Tatiana Timofeeva, Francesca Bursi, Alla Boshchenko, Olga Zhuravleva, Yi Wang, Lixue Yin, Jesus Peteiro Vazquez, Fiore Manganelli, Elisa Merli, Dimitrios Soulis, Ariel Saad, Jelena Celutkiene, Laura Balkeviciene, Sergio Kobal, Ana Djordjevic-Dikic, Nicola Gaibazzi, Clarissa Borguesan-Daros, Aleksandra Nikolic, Miodrag Ostojic, Tamara Kovacevic-Preradovic, Karina Wierzbowska-Drabik, Jaroslaw D Kasprzak, Luigi Gerra, Scipione Carerj, Quirino Ciampi, Patricia A Pellikka","doi":"10.1080/14796678.2026.2659089","DOIUrl":"10.1080/14796678.2026.2659089","url":null,"abstract":"<p><p>Stress echocardiography (SE) has evolved beyond its traditional role of detecting coronary artery disease (CAD) through a single marker-regional wall motion abnormality (RWMA). This conventional approach, while guideline-embedded, faces a declining positivity rate and reduced prognostic power in today's diverse patient population. In response, SE has undergone a conceptual transformation into a multi-marker, comprehensive functional assessment of patient vulnerability. The modern multi-marker protocol, known as the ABCDE-SE, integrates five steps during a single stress test: Step A assesses RWMA for ischemia; Step B quantifies pulmonary congestion via B-lines and E/e'; Step C evaluates left ventricular volume response; Step D measures coronary flow velocity reserve for microvascular function; and Step E determines heart rate reserve for autonomic function. Each step identifies distinct pathophysiological mechanisms and actionable therapeutic targets, significantly refining risk stratification.Developed and validated over the past decade with the SE 2030 study (2016-2030), the flagship project of SIECVI, Italian Society of Echocardiography and Cardiovascular Imaging, and adopted by 50 laboratories from 20 countries, the ABCDE protocol represents a universal and widely accessible platform, applicable to all patients with suspected cardiac disease. It paves the way for personalized medicine by enabling tailored therapies targeted to the specific vulnerabilities.</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":" ","pages":"529-539"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13215282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147768887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}